Pulmonary Alterations Flashcards
hypovent
dec alveolar vent in relation to demand
min vol dec
hypervent
ventil> demand inc ph (repir alkal), dec po2 and pco2 (hypoxemia/ hypocapnia) results- tissue ischem, coma, organ dysfunct
hypercapnia
inc CO2 in CSF
inc rate/ depth respir
dec pH (inc respir r)
causes- respir. acidosis/ depression nervo system, disease of medulla or spinal cord injury
results- cerbral vasodil = inc intracranial P
hypoxemia
dec O2 in blood
act. chemorecep
< 60 mmHg
O2Hb affinity- L and R shift
ph- inc= inc affinity (lungs) dec= dec aff (tissues) temp- inc = dec aff tissue uploading dec= inc aff- lung oxygenation left shift= inc aff right shift= dec aff (O2 released)
hemoptysis
blood stained sputum
frm lungs, trach, larynx, bronchi
orthopnea
difficulty breathing when laying down
Kussmahl breathing
deep and labored, assoc w/ ketoacid. and renal failure
“hypervent”
ventilation perfusion inequality or mismatch
v/q
air in alveoli/ blood flow in cap
normal = 0.8-0.9
shunting
low v/q, dec vent to well perfused areas
results- dec o2 sat, dyspnea
alveolar dead space
high v/q, poor perfusion
cause- inc residual co2
inhaled air not participate in gas exchange= alv damage
hypoxemia
not enough o2 avaliable
cause- abnorm v/q, inc mem thickness, edema, dec surface area
zone 1 of lungs
alve P> arterial and venous
apex
zone 2 of lungs
arterial P > alveo P
venous P < alveo P
zone 3 of lungs
base
alveol P < arterial and venous P
acute respir failure
causes- lung / chest wall injury, spinal cord/ brain injury, pulm diseases, surgical complicat
inadeq gas exchange
po2> 50 mmHg= dec alveol vent
po2< 50 mmHg= dec exchan between alveol and cap
pleural effusion
fluid in pleural space (increases alvel. P but no collapse)
results- dyspnea, pleural pain (differen from chest wall pain w/ palpation!), compression atelectasis (lung collapse), muffled lung sounds
transductive effusion
(systemic)
from left heart failure
fluid comes from capil into pleural space
exudative (local)
from infection
fluid inc wbc and protein in pleural space
cause- infection, inflamm, cancer
hemothorax
blood in pleural cavity
empyema
pus in pleural space
common cause- pneumonia
pneumothorax
collection gas in pleural cav
results- atelectasis
symptoms- dependant on size, pain and speed
primary pneumothorax
occurs idopathically
pneumothorax- secondary
due to underlying dis.
pneumothorax-open
air in w/ inspiration, forced out w/ expir.
“sucking wound”
opening in chest wall
pneumothorax- closed
no hole in chest wall
secondary
charac of restrictive lung dis
dec lung compliance
inc effort expand lungs during inspir
inc respir r and dec tidal vol
ex- pulm fibrosis or pulm edema
charact of obstructive lung dis
air obstruction worsens w/ expriation inc effort during expir symptoms- dyspnea and wheezing ex.- emphysema and asthma dec FEV forced expiratory vol results- v/q mismatch, respir failure, cor pulmonae
pulm edema
excess fluid in lungs
restrictive
causes- L sided heart failure, toxic gas inhal, ARDS
results- dyspnea, inc effort breathing, inspir crackles, hypoxemia, pink frothy sputum
acute respir distress syndrome (full) ARDS
restrictive
alveolar injury
causes- trauma, sepsis
treatment- mechanical vent
progession- hypervent, respir alkalosis, dyspnea, metab acidosis, repir acidosis, hypoxemia, hypotension, dec cardiac o, death
treatment- maintain o2 and vent, prevent infection, steroids, supportive therapy
classic ards-manifes
dyspnea, inspir crackles, dec lung complian, hypoxemia (unrespon to suppor. O2) respir alkalosis
progessive ARDS- manifes
dec tissue perfu, organ dysfun, metab acidosis, inc effort breathing, dec tidal vol, hypovent, respir acidosis, hyoxemia, hypotension, dec cardiac O, death
COPD chronic obstructive pulmon disease
obstructive
inc inflam, dec elasticity
air trapping- bronchial walls collapse (thickens or covered w/ mucus)
v/q mismatch, hypoxemia, alveo collpase
chronic bronchitis- criteria and irritants
criteria- 3 mon/year and 2 consecut years
hypersecret mucus and chronic productiv cough normal
inc size and number endothelial cells, edema, thickening bronchial walls, impaired cilliary function= inc susceptibility to infection
results- bronchospasms w/ dyspnea
chronic bronchitis- manifes, trtment, management
treatment- bronchodial, antib
manifest- productive cough, tachypnea, dyspnea, thick secretions, hypoxia, cyanosis, hypercapnia, polycythemia, weight loss
management- education (dec exposure irritants), treat infection, vacc for prophylaxis, expectorants (breakdown mucus), bronchodial (prevent bronchospasms, dec o2 flow
emphysema
brkdn alveol wall
dec sa for gas exchange, loss pulm cap, loss elasticity, altered v/q
causes- fribrosis
progression- dec expiration = overinflation (air trapping), barrel chest, rib fixation, flattened diaph
progession (advanc)- loss tissue, hypercap, infections, damaged alv = lrg air spaces, pneumothorax (air in pleural cav), weight loss, fatigue, clubbed fingers
treatment- hydration, good nutr, lung reduction surgery
asthma
obstruc
symptom- dysp, wheezing, tight chest
cause- inflam response, vasodil, cap perm, edema, muscus production, thickened airway, broncial sm musc spasms (hyperresponsiveness)
treatmnt- steroids
results- hypervent, airway obstruct, hypoxemia, dec expiration, respir acidosis
asthma atopic v non-atopic
atopic caused by allergies
laryngotracheobronchitis (CROUP)
triggered w/ acute infection upper airway
risk- 6 mon-5yrs, boys, late fall/winter
symptoms- chest wall indrawing, throat swelling, barkin cough, fever
*worse at night
management- cool moist air, corticosteroids, nebulized epinephrine
pneumonia
lwr respir tract infection
lung inflamm alveol filled w/ fluid (bac, viral, fungi or parasites)
caused- inhal organism, act inflamm response
pneumonia- community-acquired
viral or bac
affects healthy and immunocomp
pneumonia- nosocomial (hospital-acquired)
bac gram - Pseudomonas
does not infect healthy ppl
treatment- antib, incentive spir, C+DB cough and deep breath, movement
pneumonia- lobar
bac- streptococcus (gram+) localized or systemic (1+ lobe) common young adults "walking pneum" droplet transm = inflamm response sympt- fever, cough, fatigue
pneumonia- fungal
risk- immunocomp
caused- Histoplasma capsulatum
id w/ specfic lobe effected
pneumonia- parasitic
enter through skin or swallowed, travel to lungs
dec o2 transport
attract eosinoph
common antigen- toxoplasma gondii and ascarisis
pneumonia- viral
common causes- influenza, rsv (repir syncytial virus)
leads to secondary infection
bronchial epith sloughs
manifesti- fever, chills, productive or dry cough, pleural pain, dyspnea, hemoptysis (coughing up blood)
tuberculosis
antigen- mycobacterium tuberculosis
airborne droplet transm
lodge in upper lobe= act inflam response
symptoms- fever, cough, bloody sputum, weight loss, night sweats
treatment- antib
bac can become dormant = latent infection
dev scar tissue around tubercle (caseous necrosis)
pulmonary embolism (PE)
bloackage main artery/ branch lung
caused by thrombus or emboli (DVT)
obstruction reaches lungs= inc right vent P
risks- hypercoagulability, endoth vessel wall injury, venous stasis (slow blood flow)
trtmnt- filter into vena cava, mech vent, embolectomy, admin heparin or streptokinase (anticoag)
pulmonary embolism (PE)- small emboli
manifes- cough, dyspnea, transient chest pain
pulmonary embolism (PE)- large emboli
inc chest pain, dyspnea, coughing, hempytisis, fever, hypoxia, anxiety, tachyc, restlessness, cyanosis, dec o2, pallor
pulmonary embolism (PE)- massive emboli
hypotension, severe chest pain, rapid-weak pulse, palpitations, loss of consiousness, shock
cystic fibrosis
CF
scarring/ cyst formation in pancreas
bc- gene mutation with CFTR
messes w/ sweat, NaCl balance, digestive juices and mucus
risks- caucasian
can be diag before birth
progression- need lung transplant, require protein, diet management (nutrients not absorbed, bc bile not excreted)
SIDS sudden infant death syndrome
risks- <1yr
peaks at 2-4 month, more common males
usually happens when sleeping
inc risk- immunocomp or those exposed to environ stressors
pulmonary system aging
dec chest wall compliance and elasticity (recoil)
dec ventilatory reserve
dec SA gas exchange and cap perfusion
dec exercise capacity
